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Prognosis: Not good 

Editor's note: The following is a letter printed Jan. 6 in the British newspaper, The Guardian:

If a patient came into my office warning of an imminent attack on the United States with weapons of mass destruction without there being any evidence whatsoever that this would occur, and saying that we had to strike first and "take out" all those who were a threat to us as a first step towards world domination, I would diagnose him as suffering from paranoid and grandiose delusions and perhaps as psychotic. And, fearing that he constituted a potential danger to himself or others, I would commit him to a psychiatric hospital for a period of evaluation and treatment.

I suspect that some of my colleagues with licences to practise psychiatry in Washington DC are struggling with the decision to exercise their clinical, ethical, and legal responsibilities to protect the public now that the US Congress has failed to do so.

Dr. Chivian is the Co-founder of the International Physicians for the Prevention of Nuclear War, winners of the 1985 Nobel Peace Prize and Assistant Clinical Professor of Psychiatry Harvard Medical School

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